Active NPI
Raymond None Kodesch, MD
- Gastroenterology Physician
- Palm Desert, CA
National Provider Identifier
1356627236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gastroenterology Physician
- License
- G24867
- Practice address
- 263 Desert Holly Dr.
Palm Desert, CA 92211 - Phone
- (760) 345-1000
- Fax
- (760) 345-1000
- NPI assigned
- Oct 24, 2011
- Last updated
- Oct 24, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gastroenterology Physician | 207RG0100X | G24867 | CA | Primary |
Addresses
Primary practice location
263 Desert Holly Dr.
Palm Desert, CA 92211
Mailing address
263 Desert Holly Dr.
Palm Desert, CA 92211
Phone (760) 345-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G24867 | CA | MD | Gastroenterology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319414400000",
"number": "1356627236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "263 DESERT HOLLY DR.",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "92211",
"telephone_number": "760-345-1000",
"fax_number": "760-345-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "263 DESERT HOLLY DR.",
"city": "PALM DESERT",
"state": "CA",
"postal_code": "92211",
"telephone_number": "760-345-1000",
"fax_number": "760-345-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KODESCH",
"first_name": "RAYMOND",
"middle_name": "NONE",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-10-24",
"last_updated": "2011-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "CA",
"license": "G24867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Desert, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.